| NPI | 1447699541 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 309240) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2013017851) |
| Enumeration Date | 2013-06-21 |
| Last Update Date | 2025-08-20 |